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COVID-19: GP Alert (6 April 2021)

April 06, 2021

Specific clotting condition – important updates

STATEMENTS

On behalf of the Australian Government Department of Health, please find below statements published regarding a specific clotting condition being reported after COVID-19 vaccination:

Acting Chief Medical Officer and Head of the TGA
Joint statement from acting Australian Government Chief Medical Officer, Professor Michael Kidd and Head of the Therapeutic Goods Administration Adj. Professor John Skerritt.

ATAGI statement for health providers
The Australian Technical Advisory Group on Immunisation (ATAGI) released a statement to support health professionals in responding to any instances of clotting disorders following vaccine administration. This provides more information on clinical management and raises awareness of the potential for this condition.

Summary of current recommendations

  • Rare cases of thrombosis associated with thrombocytopenia were reported following administration of COVID-19 Vaccine AstraZeneca overseas.
  • The onset of reported cases was between 4 to 20 days after vaccination.
  • Providers should be aware of warning signs of a severe condition associated with thrombosis and thrombocytopenia. This has presented as either central venous sinus thrombosis (CVST) or thrombosis in other sites, such as intra-abdominal venous systems. CVST may present as a new onset persistent headache not settling with analgesia, features of raised intracranial pressure (including acute severe headache, vomiting, confusion), focal neurological deficits, and/or seizures.
  • If CVST or another severe thrombotic complication with thrombocytopenia is suspected in a patient who has received COVID-19 Vaccine AstraZeneca, refer them to an emergency department for further assessment and haematology consultation.
  • Clinical investigations should include a full blood count (to look for thrombocytopenia), a D-dimer test and radiological imaging.
  • Patients suspected to have this condition should NOT receive any heparin or platelet transfusions.
  • The TGA has received one report of a case of thrombosis and thrombocytopenia following COVID-19 Vaccine AstraZeneca in Australia. The clinical details of this case are currently under review by the TGA.

ATAGI statement for consumers

A statement from ATAGI for consumers on a specific clotting condition being reported after COVID-19 vaccination.


Additional statement from ATAGI statement

An ATAGI statement on COVID-19 vaccination and a reported case of thrombosis.


TGA statement

The TGA's assessment is that the benefits of vaccination against COVID-19 continue to outweigh any risks.

USEFUL DOCUMENTS

The Australian Government Department of Health revised the four documents below on 4 April 2021, with updates from ATAGI regarding a specific clotting condition:

NEW - COVID-19 patient resources

ELIGIBILITY CHECKER IN DIFFERENT LANGUAGES
Use the COVID-19 Vaccines Eligibility Checker to find out when you can receive a COVID-19 vaccine, book an appointment if you are eligible, or register your interest.

Now available in nine languages, including Chinese, Arabic, Vietnamese, Italian and Greek.

GUIDE FOR PEOPLE WITH WEAKENED IMMUNE SYSTEM
A guide is available for people with a weakened immune system (immunocompromise), who are considering a COVID-19 vaccine.

Historical casual contacts – information for GPs

The updated COVID-19 current contact tracing alerts and related public health advice from Queensland Health includes historical casual contacts. These locations were visited by a person who had COVID-19 but is no longer an active case or infectious. However, the person may be a link between the previous and the current COVID-19 cluster so this list includes locations and times that are older than 14 days. The locations include the PA Hospital, and venues in Everton Park, Mitchelton and the Grange in Brisbane.

Patients who have been at the listed 'historical casual contacts' locations at the specified times, including those older than 14 days, are given the following advice:

  • If you have COVID-19 symptoms, get tested immediately and quarantine at home until you receive a negative result.
  • If you do not have COVID-19 symptoms, visit a GP next week to arrange a blood test for COVID-19 serology.
  • Watch for COVID-19 symptoms and get tested if you feel unwell.

Before going to any testing clinic for a COVID-19 serology blood test

  • COVID-19 serology blood tests require a GP referral.
  • Respiratory clinics and drive through clinics set up for COVID-19 swab testing are not able to do blood testing. Also, do not go to a hospital emergency department for a serology test.